Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: results of the protect study. Issue 2 (22nd March 2013)

• Record Type: Journal Article
• Authors: Jiménez, David; Lobo, José Luis; Monreal, Manuel; Moores, Lisa; Oribe, Mikel; Barrón, Manuel; Otero, Remedios; Nauffal, Dolores; Rabuñal, Ramón; Valle, Reina; Navarro, Carmen; Rodríguez-Matute, Consolación; Álvarez, Celso; Conget, Francisco; Uresandi, Fernando; Aujesky, Drahomir A; Yusen, Roger D
• Other Names: Álvarez Celso author non-byline.; Abaitúa Jose María author non-byline.; Abraira Víctor author non-byline.; Alonso Ángel author non-byline.; Alonso Luis Javier author non-byline.; Ballaz Aitor author non-byline.; Ballester Marta author non-byline.; Barrón Manuel author non-byline.; Briongos Sem author non-byline.; Castañer Eva author non-byline.; Castro Olalla author non-byline.; Conget Francisco author non-byline.; Cuesta José María author non-byline.; Elías Teresa author non-byline.; Gómez Vicente author non-byline.; Gallego Ignacio author non-byline.; González Mariano author non-byline.; Gorospe Luis author non-byline.; Guillaumet Eva author non-byline.; Iglesias Concepción author non-byline.; Jiménez David author non-byline.; López Francisco author non-byline.; López Mónica author non-byline.; Lladó María author non-byline.; Lobo José Luis author non-byline.; Lucio Pilar author non-byline.; Marín Jesús author non-byline.; Martín María author non-byline.; Monreal Manuel author non-byline.; Muriel Alfonso author non-byline.; Nauffal Dolores author non-byline.; Navarro Carmen author non-byline.; Oribe Mikel author non-byline.; Osa Ana author non-byline.; Otero Remedios author non-byline.; Pamies José author non-byline.; Piret María Victoria author non-byline.; Pozo Delfina author non-byline.; Prieto Amador author non-byline.; Rabuñal Ramón author non-byline.; Rodríguez Consolación author non-byline.; Rodríguez Nuria author non-byline.; Rodrigo Carmen author non-byline.; Santolaria Miguel Ángel author non-byline.; Serrano Pilar author non-byline.; Testa Ana author non-byline.; Uresandi Fernando author non-byline.; Valle Reina author non-byline.; Velasco Sonia author non-byline.; Vicente Agustina author non-byline.; Vivancos Jorge author non-byline.; Yusen Roger D. author non-byline.; Zamora Javier author non-byline.; Zorrilla Vanesa author non-byline.; de Benito José Luis author non-byline.; del Rey José Manuel author non-byline.;
• Is Part Of: Thorax. Volume 69:Issue 2(2014)
• Page Start: 109
• Page End: 115
• Publication Date: 2013-03-22
• Subjects: Pulmonary Embolism; Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2012-202900
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: In patients with acute pulmonary embolism (PE), rapid and accurate risk assessment is paramount in selecting the appropriate treatment strategy. The prognostic value of right ventricular dysfunction (RVD) assessed by multidetector CT (MDCT) in normotensive patients with PE has lacked adequate validation. Methods: The study defined MDCT-assessed RVD as a ratio of the RV to the left ventricle short axis diameter greater than 0.9. Outcomes assessed through 30 days after the diagnosis of PE included all-cause mortality and 'complicated course', which consisted of death from any cause, haemodynamic collapse or recurrent PE. Results: MDCT detected RVD in 533 (63%) of the 848 enrolled patients. Those with RVD on MDCT more frequently had echocardiographic RVD (31%) than those without RVD on MDCT (9.2%) (p<0.001). Patients with RVD on MDCT had significantly higher brain natriuretic peptide (269±447 vs 180±457 pg/ml, p<0.001) and troponin (0.10±0.43 vs 0.03±0.24 ng/ml, p=0.001) levels in comparison with those without RVD on MDCT. During follow-up, death occurred in 25 patients with and in 13 patients without RVD on MDCT (4.7% vs 4.3%; p=0.93). Those with and those without RVD on MDCT had a similar frequency of complicated course (3.9% vs 2.3%; p=0.30). Conclusions: The PROgnosTic valuE of CT study showed a relationship between RVD assessed by MDCT and other markers of cardiac dysfunction around the time of PE diagnosis, but did not demonstrate an association between MDCT–RVD and prognosis.